Planning retention strategies in clinical trials; a qualitative interview study with members of trial teams.

Authors

Ellen Murphy, Sharon McCann, Frances Shiely, Katie Gillies

Published in

Journal of clinical epidemiology. Pages 111979. Sep 19, 2025. Epub Sep 19, 2025.

Abstract

To address poor participant retention, trial teams often use retention strategies. Evidence on the planning of retention strategies in trials is limited. Based on our previously conducted research, and other existing literature, it is unclear whether retention strategies are prospectively or retrospectively planned by trialists. Our objective was to investigate this.
One-to-one semi structured interviews, online or in-person, were conducted with trialists in the UK and Ireland to gain better insights into planning retention strategies across various trialists viewpoints. Purposive snowball sampling was used to recruit interviewees. Data were analysed using Framework analysis. This approach was chosen to aid in identifying similarities and differences in patterns in the data within and between different groups of trialists interviewed, e.g., Trial Managers, Research Nurses, Principal Investigators etc. RESULTS: Twenty-four trialists were interviewed including, Trial Managers, Study Co-ordinators, Principal Investigators, Research Nurses, a Head of Trial Operations, a Clinical Trial Unit Director, a Clinical Trial Monitor, a Co-Investigator, and a Clinical Trials Practitioner. Findings show that the development of retention strategies in trials is mostly done proactively during the design and planning stages of the trial, i.e., during trial design and protocol development. Participant retention, however, is an ongoing process and if retention rates are problematic additional strategies are reactively planned and implemented. Strategies tend to be chosen by the core trial management team, and the choice of strategy is mainly guided by prior experience. A variety of different formal strategies, (explicitly and intentionally planned strategies that are often more structured, such as, reminders or incentives), are used to facilitate ongoing participant retention. Informal strategies (not explicitly or intentionally planned) such as, building rapport with participants, and having motivated and invested trial staff, are also highlighted as being important to facilitating retention in trials.
Most trialists proactively plan and implement retention strategies during the design and planning stages of the trial but are also responsive to poor retention rates as the trial is ongoing. Currently retention strategies are chosen based on prior experience of using the strategy. More formal evaluation of effectiveness is needed to help facilitate evidence-based decision making when choosing retention strategies.

PMID:
40976518
Bibliographic data and abstract were imported from PubMed on 22 Sep 2025.

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